Are United States and Canadian Cancer Screening Rates Consistent With Guideline Information Regarding the Age of Screening Initiation?

International Journal for Quality in Health Care, in press

Posted: 22 Aug 2011

See all articles by Srikanth Kadiyala

Srikanth Kadiyala

RAND Corporation

Erin Strumpf

McGill University - Department of Economics; McGill University - Department of Epidemiology, Biostatistics, and Occupational Health

Date Written: August 1, 2011

Abstract

Objective. To understand whether US and Canadian breast, colorectal and prostate cancer screening test utilization is consistent with US and Canadian cancer screening guideline information with respect to the age of screening initiation.

Design. Cross-sectional, regression discontinuity.

Setting. Canada and US.

Participants. Canadian and US women of ages 30–60 and men of ages 40–6'3

Interventions. None.

Main Outcomes Measures. Mammography, prostate-specific antigen (PSA) and colorectal cancer test use within the past 2 years.

Methods. We identify US and Canadian compliance with age screening information in a novel manner, by comparing test utilization rates of individuals who are immediately on either side of the guideline recommended initiation ages.

Results. US mammography utilization within the last 2 years increased from 33% at age 39 to 48% at age 40 and 60% at age 41. US colorectal cancer test utilization, within the last 2 years, increased from 15% at age 49 to 18% at age 50 and 28% at age 51. US PSA utilization within the last 2 years increased from 37% at age 49 to 44% at age 50 and 54% at age 51. In Canada, mammography utilization within the last 2 years increased from 47% at age 49 to 57% at age 50 and 66% at age 51.

Conclusion. US and Canadian cancer screening utilization is generally consistent with each country’s guideline recommendations regarding age. US and Canadian differences in screening due to guidelines can potentially explain cross-country differences in breast cancer mortality and affect interpretation of international comparisons of cancer statistics.

Keywords: health policy, guidelines, cancers, prevention (incl. screening)

JEL Classification: I1

Suggested Citation

Kadiyala, Srikanth and Strumpf, Erin, Are United States and Canadian Cancer Screening Rates Consistent With Guideline Information Regarding the Age of Screening Initiation? (August 1, 2011). International Journal for Quality in Health Care, in press. Available at SSRN: https://ssrn.com/abstract=1913941

Srikanth Kadiyala

RAND Corporation ( email )

1776 Main Street
P.O. Box 2138
Santa Monica, CA 90407-2138
United States

Erin Strumpf (Contact Author)

McGill University - Department of Economics ( email )

855 Sherbrooke Street West
Montreal, QC H3A 2T7
CANADA

McGill University - Department of Epidemiology, Biostatistics, and Occupational Health ( email )

Montreal
United States

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